Category: S

Generally, any institution, individual or agency that furnishes a medical item or service. In Medicare, suppliers are distinguished from providers, including hospitals, and skilled nursing facilities. Institutions classified as providers are reimbursed by intermediaries on a reasonable cost basis while suppliers, including physicians, nonhospital laboratories and ambulance companies, are paid by carriers on the basis…

The voluntary portion of Medicare in which all persons entitled to the hospital insurance program (Part A) may enroll. The program is financed on a current basis from monthly premiums (presently $6.70) paid by persons insured under the program and a matching amount from Federal general revenues. About 95 percent of eligible people are enrolled.…

The optional services which HMOs may provide in addition to basic health services and still qualify for Federal assistance. They are defined in section 1302(2) of the PHS Act.  

Health insurance which covers medical expenses not covered by separate health insurance already held by the insured, e.g. which supplements another insurance policy. For example, many insurance companies sell insurance to people covered under Medicare which covers either the costs of cost-sharing required by Medicare, services not covered, or both. Where cost-sharing is intended to…

Often used synonymously with either member or beneficiary but in a strict sense means only the individual (family head or employee) who has elected to contract for, or participate in (subscribe to) an insurance or HMO plan for either himself or himself and his eligible dependents. As used in health insurance and with prepayment plans,…

A provision of an insurance policy which requires an insured individual to turn over any rights he may have to recover damage from another party to the insurer, to the extent to which he has been reimbursed by the insurer. Some experts have argued that private health insurance (including Blue Cross or group insurance) should…

An incomplete or partial dislocation of two adjacent vertebrae. Normally the vertebral bodies are squarely situated atop one another; however, when such things as trauma or certain forms of arthritis intervene, one vertebral body may shift with respect to its neighbor. When the shift does not completely abolish contact between the two normally adjacent surfaces…

A deep-massage technique, developed by Ida P. Rolf, Ph. D., which is designed to help a person realign the body by altering the length and tone of myofascial tissues. Practitioners of Rolfing, as the technique is commonly known, believe that misalignment resulting from inaccurate learning about posture, as well as emotional and physical trauma, may…

A company owned and controlled by stockholders and operated for the purpose of making a profit, and contrasted with a mutual Insurance company. Li the former the profits go to the owners, in the latter they go the insured.  

Section 1521 of the PHS Act, added requires the establishment of State health planning and development agencies in each State. As a replacement for existing State CHP agencies, SHPDAs will prepare an annual preliminary State health plan and the State medical facilities plan {Hill-Burton). The agency will also serve as the designated review agency for…